Examining the Role of the Mood Disorder Questionnaire in Diagnosing Psychiatric Disorders

A new study from researchers at Rhode Island Hospital questions the effectiveness of the Mood Disorder Questionnaire (MDQ), a long-time staple in the diagnosis of bipolar disorder.

Lead author Mark Zimmerman, MD, director of outpatient psychiatry at Rhode Island Hospital and associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University, and his research team interviewed nearly 500 patients, using the Structured Clinical Interview for Diagnostic Statistical Manual IV (DSM-IV) and the Structured Interview for DSM-IV for personality disorders; the patients also completed the MDQ. Results of the screening tests showed that patients with a positive indication for bipolar disorder, based on the MDQ results, were just as likely to be diagnosed with borderline personality disorder as bipolar disorder when using the structured clinical interview. In addition, the researchers found that borderline personality disorder was diagnosed four times more frequently “in the group who screen positive on the MDQ.”

Writing in the early online edition of the Journal of Clinical Psychiatry, the researchers concluded: “Positive results on the MDQ were as likely to indicate that a patient has borderline personality disorder as bipolar disorder,” making the clinical utility of the MDQ in routine clinical practice “uncertain.”

The lack of a definitive diagnosis of either condition may lead to incorrect treatment regimens, Zimmerman said, noting that treatment for bipolar disorder typically involves medication and that there currently is no pharmacologic treatment approved for borderline personality disorder.

“Without an accurate diagnosis of borderline personality disorder, we may have many people in treatment who are taking medications that will not work to alleviate the characteristics of the condition from which they really suffer,” Zimmerman continued. “In addition, patients with unrecognized borderline personality disorder will not be treated with one of the effective psychotherapies for this condition. It is therefore vital that we develop or identify a more accurate method to distinguish between these two conditions, and adopt it into clinical practice.”